피부이식 및 피판재건술을 이용한 외음부 파제트병 치료 3예
PAGET’S DISEASE OF THE VULVA TREATED BY WIDE EXCISION AND RECONSTRUCTION WITH SKIN GRAFTS AND FLAPS: REPORTS OF THREE CASES
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초록
유방외 파제트병은 서서히 진행하는 홍반성 습진양 피부 병변으로 주로 폐경 여성에서 발생하는 비교적 드문 상피내선암종이다. 외음부파제트병은 전체 외음부 종양의 약 1% 이하를 차지하며, 광범위 국소절제술이 가장 좋은 치료 방법으로 알려져 있다. 그러나 재발을 방지하기 위해 충분한 절제연을 설정하여 광범위 절제술을 시행할 경우, 단순 봉합만으로 결손 부위를 재건하는 것은 매우 어려우므로 피부이식과 피판술을 이용한 재건술이 상당히 유용할 수 있다. 저자들은 피하조직을 포함한 광범위 국소절제술 후 피부이식과 피판술을 이용한회음부재건술을 시행하여 성공적으로 치료하였던 외음부 파제트병 3예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
Abstract
Extramammary Paget’s disease is a rare, slow-growing, non-invasive intraepithelial adenocarcinoma that occurs mainly in the elderly outside of the mammary gland. Paget’s disease of the vulva accounts for less than 1% of all vulvar malignancies. The standard treatment is wide local excision of the gross lesion. To prevent a relapse, wide excision with adequate margins is necessary not to leave pathologic lesions around margins of excision. However, since the excised area is too wide to cover all the exposed surface with a simple closure only, skin grafts and fl aps can be very useful. We report successful treatment of three cases of extramammary Paget’s disease of the vulva using frozen section analyses of the margins during operation in order to attain Paget’s cells free margins and skin grafts and fl aps to cover an extensive defects.
참고문헌 (15)
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